Women with prior gestational diabetes mellitus and prediabetes are characterised by a decreased incretin effect

Signe Foghsgaard; Louise Vedtofte; Camilla Andreasen; Emilie S Andersen; Emilie Bahne; Jonatan I Bagger; Jens A Svare; Jens J Holst; Tine D Clausen; Elisabeth R Mathiesen; Peter Damm; Filip K Knop; Tina Vilsbøll

doi:10.1007/s00125-017-4265-8

Women with prior gestational diabetes mellitus and prediabetes are characterised by a decreased incretin effect

Signe Foghsgaard, Louise Vedtofte, Camilla Andreasen, Emilie S Andersen, Emilie Bahne, Jonatan I Bagger, Jens A Svare, Jens J Holst, Tine D Clausen, Elisabeth R Mathiesen, Peter Damm, Filip K Knop, Tina Vilsbøll

Department of Clinical Medicine

8 Citations (Scopus)

Abstract

Aims/hypothesis: We investigated whether a reduced incretin effect, as observed in patients with type 2 diabetes, can be detected in high-risk individuals, such as women with prior gestational diabetes mellitus (pGDM). Methods: In this cross-sectional study, 102 women without diabetes with pGDM and 15 control participants without pGDM and with normal glucose tolerance (NGT) underwent a 4 h 75 g OGTT and an isoglycaemic i.v. glucose infusion (IIGI). Women with pGDM were classified as having NGT or prediabetes (impaired fasting glucose and/or impaired glucose tolerance). Insulin sensitivity was assessed using the Matsuda index and HOMA2-IR and the incretin effect was calculated from insulin responses during the study (100% × [AUC_insulin,OGTT − AUC_insulin,IIGI]/AUC_insulin,OGTT). Results: Sixty-three of the 102 women with pGDM (62%) had prediabetes (median [interquartile range]: age, 38.3 [6.5] years; BMI, 32.1 [5.8] kg/m²) and 39 women (38%) had NGT (age, 39.5 [5.6] years; BMI, 31.0 [6.7] kg/m²). Control participants (n = 15) were not significantly different from the pGDM group with regards to age (39.2 [7.4] years) and BMI (28.8 [9.2] kg/m²). Compared with women with NGT and control participants, women with prediabetes had lower insulin sensitivity, as measured by the Matsuda index (3.0 [2.4] vs 5.0 [2.6] vs 1.5 [1.8], respectively; p < 0.001). The incretin effect was 55.3% [27.8], 73.8% [19.0] and 76.7% [24.6] in women with prediabetes, women with normal glucose tolerance and control participants, respectively (p < 0.01). Conclusion/interpretation: Prediabetes was highly prevalent in women with pGDM, and alterations in the incretin effect were detected in this group before the development of type 2 diabetes. Trial registration:: clinicaltrialsregister.eu 2012-001371-37-DK.

Original language	English
Journal	Diabetologia
Volume	60
Issue number	7
Pages (from-to)	1344-1353
Number of pages	10
ISSN	0012-186X
DOIs	https://doi.org/10.1007/s00125-017-4265-8
Publication status	Published - 1 Jul 2017

Keywords

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Foghsgaard, S., Vedtofte, L., Andreasen, C., Andersen, E. S., Bahne, E., Bagger, J. I., Svare, J. A., Holst, J. J., Clausen, T. D., Mathiesen, E. R., Damm, P., Knop, F. K., & Vilsbøll, T. (2017). Women with prior gestational diabetes mellitus and prediabetes are characterised by a decreased incretin effect. Diabetologia, 60(7), 1344-1353. https://doi.org/10.1007/s00125-017-4265-8

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abstract = "Aims/hypothesis: We investigated whether a reduced incretin effect, as observed in patients with type 2 diabetes, can be detected in high-risk individuals, such as women with prior gestational diabetes mellitus (pGDM). Methods: In this cross-sectional study, 102 women without diabetes with pGDM and 15 control participants without pGDM and with normal glucose tolerance (NGT) underwent a 4 h 75 g OGTT and an isoglycaemic i.v. glucose infusion (IIGI). Women with pGDM were classified as having NGT or prediabetes (impaired fasting glucose and/or impaired glucose tolerance). Insulin sensitivity was assessed using the Matsuda index and HOMA2-IR and the incretin effect was calculated from insulin responses during the study (100% × [AUCinsulin,OGTT − AUCinsulin,IIGI]/AUCinsulin,OGTT). Results: Sixty-three of the 102 women with pGDM (62%) had prediabetes (median [interquartile range]: age, 38.3 [6.5] years; BMI, 32.1 [5.8] kg/m2) and 39 women (38%) had NGT (age, 39.5 [5.6] years; BMI, 31.0 [6.7] kg/m2). Control participants (n = 15) were not significantly different from the pGDM group with regards to age (39.2 [7.4] years) and BMI (28.8 [9.2] kg/m2). Compared with women with NGT and control participants, women with prediabetes had lower insulin sensitivity, as measured by the Matsuda index (3.0 [2.4] vs 5.0 [2.6] vs 1.5 [1.8], respectively; p < 0.001). The incretin effect was 55.3% [27.8], 73.8% [19.0] and 76.7% [24.6] in women with prediabetes, women with normal glucose tolerance and control participants, respectively (p < 0.01). Conclusion/interpretation: Prediabetes was highly prevalent in women with pGDM, and alterations in the incretin effect were detected in this group before the development of type 2 diabetes. Trial registration:: clinicaltrialsregister.eu 2012-001371-37-DK.",

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doi = "10.1007/s00125-017-4265-8",

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T1 - Women with prior gestational diabetes mellitus and prediabetes are characterised by a decreased incretin effect

AU - Foghsgaard, Signe

AU - Vedtofte, Louise

AU - Andreasen, Camilla

AU - Andersen, Emilie S

AU - Bahne, Emilie

AU - Bagger, Jonatan I

AU - Svare, Jens A

AU - Holst, Jens J

AU - Clausen, Tine D

AU - Mathiesen, Elisabeth R

AU - Damm, Peter

AU - Knop, Filip K

AU - Vilsbøll, Tina

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N2 - Aims/hypothesis: We investigated whether a reduced incretin effect, as observed in patients with type 2 diabetes, can be detected in high-risk individuals, such as women with prior gestational diabetes mellitus (pGDM). Methods: In this cross-sectional study, 102 women without diabetes with pGDM and 15 control participants without pGDM and with normal glucose tolerance (NGT) underwent a 4 h 75 g OGTT and an isoglycaemic i.v. glucose infusion (IIGI). Women with pGDM were classified as having NGT or prediabetes (impaired fasting glucose and/or impaired glucose tolerance). Insulin sensitivity was assessed using the Matsuda index and HOMA2-IR and the incretin effect was calculated from insulin responses during the study (100% × [AUCinsulin,OGTT − AUCinsulin,IIGI]/AUCinsulin,OGTT). Results: Sixty-three of the 102 women with pGDM (62%) had prediabetes (median [interquartile range]: age, 38.3 [6.5] years; BMI, 32.1 [5.8] kg/m2) and 39 women (38%) had NGT (age, 39.5 [5.6] years; BMI, 31.0 [6.7] kg/m2). Control participants (n = 15) were not significantly different from the pGDM group with regards to age (39.2 [7.4] years) and BMI (28.8 [9.2] kg/m2). Compared with women with NGT and control participants, women with prediabetes had lower insulin sensitivity, as measured by the Matsuda index (3.0 [2.4] vs 5.0 [2.6] vs 1.5 [1.8], respectively; p < 0.001). The incretin effect was 55.3% [27.8], 73.8% [19.0] and 76.7% [24.6] in women with prediabetes, women with normal glucose tolerance and control participants, respectively (p < 0.01). Conclusion/interpretation: Prediabetes was highly prevalent in women with pGDM, and alterations in the incretin effect were detected in this group before the development of type 2 diabetes. Trial registration:: clinicaltrialsregister.eu 2012-001371-37-DK.

AB - Aims/hypothesis: We investigated whether a reduced incretin effect, as observed in patients with type 2 diabetes, can be detected in high-risk individuals, such as women with prior gestational diabetes mellitus (pGDM). Methods: In this cross-sectional study, 102 women without diabetes with pGDM and 15 control participants without pGDM and with normal glucose tolerance (NGT) underwent a 4 h 75 g OGTT and an isoglycaemic i.v. glucose infusion (IIGI). Women with pGDM were classified as having NGT or prediabetes (impaired fasting glucose and/or impaired glucose tolerance). Insulin sensitivity was assessed using the Matsuda index and HOMA2-IR and the incretin effect was calculated from insulin responses during the study (100% × [AUCinsulin,OGTT − AUCinsulin,IIGI]/AUCinsulin,OGTT). Results: Sixty-three of the 102 women with pGDM (62%) had prediabetes (median [interquartile range]: age, 38.3 [6.5] years; BMI, 32.1 [5.8] kg/m2) and 39 women (38%) had NGT (age, 39.5 [5.6] years; BMI, 31.0 [6.7] kg/m2). Control participants (n = 15) were not significantly different from the pGDM group with regards to age (39.2 [7.4] years) and BMI (28.8 [9.2] kg/m2). Compared with women with NGT and control participants, women with prediabetes had lower insulin sensitivity, as measured by the Matsuda index (3.0 [2.4] vs 5.0 [2.6] vs 1.5 [1.8], respectively; p < 0.001). The incretin effect was 55.3% [27.8], 73.8% [19.0] and 76.7% [24.6] in women with prediabetes, women with normal glucose tolerance and control participants, respectively (p < 0.01). Conclusion/interpretation: Prediabetes was highly prevalent in women with pGDM, and alterations in the incretin effect were detected in this group before the development of type 2 diabetes. Trial registration:: clinicaltrialsregister.eu 2012-001371-37-DK.

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DO - 10.1007/s00125-017-4265-8

M3 - Journal article

C2 - 28364253

SN - 0012-186X

VL - 60

SP - 1344

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JO - Diabetologia

JF - Diabetologia

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ER -

Women with prior gestational diabetes mellitus and prediabetes are characterised by a decreased incretin effect

Abstract

Keywords

UN SDGs

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